A high prevalence of hepatitis C virus
infection in
porphyria cutanea tarda in some populations suggests a close link between viral
hepatitis and alteration of
porphyrin metabolism. Moreover, there is evidence of a role of porphyrinopathies in hepatocarcinogenesis. The aim of our study was to obtain data on the prevalence and patterns of
heme metabolism alterations in patients with
chronic hepatitis C virus infection. Urinary
porphyrin excretion was prospectively studied in 100 consecutive outpatients with
chronic hepatitis C infection without signs of photosensitivity, using an ion-pair high-performance liquid chromatography method. Increased total
porphyrin excretion was found in 41 patients, with predominant excretion of
coproporphyrins (whole study group: mean 146 microg/g
creatinine, interquartile range 76-186; normal < 150), in 10 patients excretion exceeded 300 microg/g
creatinine. In the majority of all patients studied (75/100) an increased ratio of the relatively hydrophobic coproporphyrin isomer I to isomer III was found. In just one case, urinary
porphyrin pattern characteristic for chronic
hepatic porphyria was present (uroporphyrin > coproporphyrin, heptacarboxyporphyrin III increased) but the total
porphyrin excretion was only slightly elevated in this case. In the whole group, total urinary
porphyrin excretion correlated well with serum
bilirubin and was inversely correlated with
albumin and thrombin time. In conclusion, secondary coproporphyrinuria occurs frequently in heptatitis C
infection, whereas in Germany, preclinical
porphyria cutanea tarda seems to be rare in these patients.